NOTE: Updated information about practice guidelines, training opportunities, and books can be found at HelpingTheSuicidalPerson.com.
If you are a psychotherapist, it is likely that your graduate studies included precious little training in suicide prevention. You can get that knowledge in other ways. To name a few:
Practice Guidelines for Treating Suicidal Clients
Several organizations have published guidelines for clinical practice with suicidal individuals. Those practice guidelines contain a wealth of information on topics related to suicide risk assessment, treatment planning, interventions, safety planning, and more:
VA/DoD Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide
This clinical practice guideline is from the Veteran’s Administration and Department of Defense, but the content is applicable to all adults. Topics include risk assessment, management of urgent or emergent risk, treatment interventions based on the different levels of risk, safety planning, and continual monitoring and re-assessment.
Published by the Victoria (Australia) Department of Health, these guidelines go beyond the standard material on the assessment and management of suicide risk. In addition, they include guidelines related to special populations such as the elderly and the chronically suicidal, aggression in emergency departments, and bereavement services.
American Association for Suicidology Annual Conference
This conference, held every April, consistently features excellent presentations on clinical interventions with clients at risk for suicide, including those with intense suicidal thoughts or a recent suicide attempt. Pre-conference training workshops, lasting from a half day to two days, are especially salient. You usually can find information about upcoming and past conferences at the American Association for Suicidology website.
University Courses on Suicide Assessment and Intervention
Suicide-specific courses are the exception rather than the norm, but they do exist. Check with your local university to see what’s available.
Continuing Education Courses about Helping Suicidal Clients
Numerous outfits offer continuing education courses, including universities, professional organizations, training institutes, and businesses like PESI.com. Opportunities often come and go, so here I am listing some classes that are offered on a fairly consistent basis:
Assessing and Managing Suicide Risk
This one day workshop, offered by the Suicide Prevention Resource Center, is based on core competencies that are considered essential to assessing and managing suicidality. These competencies include examining one’s attitudes and approach toward suicidal people, understanding suicide, gathering accurate information from the client, formulating the client’s level of suicide risk, developing a treatment plan, documenting the assessment and treatment, and understanding legal issues related to working with suicidal clients.
Recognizing and Responding to Suicide Risk
This 2-day training is similar to the Assessing and Managing Suicide Risk course described above, while also expanding on it with experiential exercises and clinical case studies.
Suicide Risk Assessment (3 hours)
Suicide Risk Assessment and Management (6 hours)
The above two courses are offered through Behavioral Tech, LLC, which was founded by Marsha Linehan, PhD, the developer of dialectical behavior therapy (DBT). The courses Suicide Risk Assessment and Suicide Risk Management are each 3 hours long. Treatment with Suicidal Persons is 6 hours long. Suicide: DBT Protocol for Assessing and Managing Risk is usually 2 days long.
Cognitive Behavior Therapy for Depression and Suicide
This 3-day workshop includes a day of instruction devoted to CBT with suicidal clients. Topics include risk assessment, techniques for preventing and managing suicidal crises, and ethical issues.
Community Training Opportunities in Suicide Prevention
Several groups offer suicide prevention training to lay people, and these trainings also have value for professionals. Here, I describe three particularly well known workshops offered to communities.
Applied Suicide Intervention Skills and Techniques (ASIST) and SafeTALK
This 2-day ASIST training covers important, basic skills such as recognizing suicide risk, planning for safety, intervening effectively, tapping into community resources, and avoiding stigma and judgment in work with suicidal people. An added bonus is that many ASIST trainings are subsidized by the groups that offer them; for example, in Colorado some trainings are offered for only $50.
The group that developed ASIST, LivingWorks, also has another training, SafeTALK. This 3-hour class is focused on helping people to “move beyond common tendencies to miss, dismiss or avoid suicide,” recognize people who are thinking of suicide, and connect person with suicidal thoughts to “suicide first aid.” (TALK stands for Tell, Ask, Listen, and Keep Safe.)
To see whether any ASIST or SafeTALK workshops are scheduled near you, check out LivingWork’s Find-A-Training site.
QPR Gatekeeper Training for Suicide Prevention
QPR (Question, Persuade, Refer) is a course designed for “community gatekeepers” – that is, people who might be in a position to encounter a suicidal person and refer the person to a professional. This 1-hour course may be rudimentary for mental health professionals who are already well versed in risk factors for suicide. The QPR Institute also offers more advanced courses on an online basis, which I describe below.
Online Training in Suicide Assessment and Intervention
You have several options for online training. Some are even free.
The one-hour QPR training course is pretty basic for professionals. The advanced courses are better suited to clinical practice. They each take anywhere from 3 to 12 hours to complete (not including the Online Counseling and Suicide Intervention Specialist course, which takes 40 hours):
Suicide Prevention Resource Center (SPRC) Online Training
SPRC offers free, self-paced online courses related to suicide prevention. Right now the courses are designed primarily for administrators, researchers, and policy planners. One course is immediately applicable to practice: Counseling on Access to Lethal Means (CALM).
Webinars on Suicide Assessment and Intervention
There may be no such thing as a free lunch, but the Internet contains an amazing amount of free webinars on topics related to suicide prevention, sponsored by various organizations:
Massachusetts Coalition for Suicide Prevention
This suicide prevention coalition has sponsored numerous webinars since 2010. The group keeps the webinars (and their transcripts) available to others on the site’s webinar library. Topics include suicide prevention in relation to bullying, veterans, Black youth, transgender communities, schools, older adults, sexual assault survivors, eating disorders, and self injury. Two webinars also address grief and healing after suicide loss.
This Canadian organization has an excellent series of webinars centered on the theme “The 5 Things We Wish All Teachers Knew about….” Though targeted at teachers, the webinars contain information that is valuable to anybody who encounters suicidal youth. Topics include “The 5 Things We Wish All Teachers Knew About…”
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- Anxiety Disorders, Depression, and Suicide
- Lesbian-Gay-Bisexual-Transgendered Youth and Suicide
- How to Talk to Parents About a Child at Risk of Suicide
- Substance Use and Suicide
- Social Media, Contagion and Suicide
- Self-harm and Suicide
Mental Health Commission of Canada
This group’s suicide prevention webinar series covers topics such as community suicide prevention, trauma-informed care, injury prevention, and the use of technology (such as apps) in suicide prevention.
Suicide Prevention and Resource Center
The Research to Practice webinar series contains more than 30 webinars recorded since 2004. Many are oriented toward research, policy, or community suicide prevention, but they still have relevance to clinicians. Webinar topics include a Native community’s successful suicide prevention strategy, suicide prevention in rural primary care settings, alcohol use and suicide, and bullying and suicide.
Books about Suicide Assessment and Intervention
In this site’s Resources section for mental health professionals, I recommend in more depth several books on assessing and treating suicidality. Here is a simple list of those books and many more:
Adolescent Suicide: An Integrated Approach to the Assessment of Risk and Protective Factors, by Peter M. Gutierrez, PhD, and Augustine Osman, PhD
Adolescent Suicide: Assessment and Intervention, by Alan L. Berman, PhD, David A. Jobes, PhD, and Morton M. Silverman, MD
The American Psychiatric Publishing Textbook of Suicide Assessment and Management, by Robert I. Simon, MD, and Robert E. Hales, MD, MBA
The Assessment and Management of Suicidality, by M. David Rudd, PhD
Building a Therapeutic Alliance with the Suicidal Patient, Edited by Konrad Michel, MD, and David A. Jobes, PhD
Clinical Manual for Assessment and Treatment of Suicidal Patients, by John A. Chiles, MD, and Kirk D. Strosahl, PhD
Cognitive Therapy for Suicidal Patients: Scientific and Clinical Applications, by Amy Wenzel, PhD, Gregory K. Brown, PhD, and Aaron T. Beck, MD
Comprehensive Textbook of Suicidology, by Ronald W. Maris, PhD, Alan L. Berman, PhD, and Morton M. Silverman, MD
Dialectical Behavior Therapy with Suicidal Adolescents, by Alec L. Miller, PsyD, Jill Rathus, PhD, and Marsha M. Linehan, PhD
Managing Suicidal Risk: A Collaborative Approach, by David A. Jobes, PhD
Myths about Suicide,by Thomas Joiner, PhD
Night Falls Fast: Understanding Suicide, by Kay Redfield Jamison, PhD
The Practical Art of Suicide Assessment: A Guide for Mental Health Professionals and Substance Abuse Counselors, by Shawn C. Shea, MD
Preventing Patient Suicide: Clinical Assessment and Management, by Robert I. Simon, MD
The Suicidal Mind, by Edwin S. Shneidman, PhD
The Suicidal Patient: Clinical and Legal Standards of Care, by Bruce Bongar, PhD, and Glenn Sullivan, PhD
Teen Suicide Risk: A Practitioner Guide to Screening, Assessment, and Management, by Cheryl A. King, PhD, Cynthia Ewell Foster, PhD, and Kelly M. Rogalski, MD
Treating Suicidal Behavior: An Effective, Time-Limited Approach, by M. David Rudd, PhD, Thomas Joiner, PhD, and Hasan Rajab, PhD
Why People Die by Suicide, by Thomas Joiner, PhD
Where Else Can You Learn about Suicide Assessment, Intervention, and Prevention?
The list I provide here of ways to improve suicide prevention skills is by no means exhaustive. If you know of an option not listed here that you would like to share, please feel free to leave a comment!
© 2014 Stacey Freedenthal, PhD, LCSW, All Rights Reserved. Written for www.speakingofsuicide.com
Stacey, your work and this site are incredibly helpful. Thank you!
seems hard to be able to leave comments anymore probably due to how people abuse the privilege. Hopefully this will post. This topic of suicide is such a pressing one that I have to add my 2 cents, as a health care professional who has worked in mental health and also a patient with major depressive disorder. I just had a PHQ9 two days ago at my MD office, scored a 15, but noted an issue with one of the questions. “Have you ever felt the world would be better off without you?” I answered no or “0” because most of the time when I’m in a ‘baseline’ state of suicidality I couldn’t give a rats you know what about the world. Where I’m going with on this point is that the suicidality measures most used are focused too much on the “acutely” suicidal individual. I would guess that most successful suicides are not that type. They are of the ‘simmering’ type. The chronically depressed and suicidal individual reaches a tipping point in their pain. At this point, the question becomes not “why” they committed suicide, but “why not”. Contrary to the prevailing views on the depressive mind, the act of suicide, at the time of the act, does in fact make sense from a rational standpoint. One has to consider the “why not”. The person who commits suicide, in my opinion, is not concerned about the effect of their act on others. Is that “selfish?” Probably – by definition. Depression, like other forms of physical pain cause a person to become self focused on their intense discomfort. A person rarely kills themselves because of, purely, physical pain. That is why depression is the most devastating of all pain. The most consuming. We need to understand the depressed patient better. Stop asking “why?” after they are gone, and start attending to their pain BEFORE they ask themselves “why not?”
Stacey, thank you so much for sharing these great resources! I will definitely be sharing a link to this post with the therapists I know!
Thank you, Tamara, for helping to get the word out about ways to improve suicide prevention skills! I appreciate your support.